Epileptic discharges initiate from brain areas with elevated accumulation of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors

Brain Communications - Tập 4 Số 2 - 2022
Tomoyuki Miyazaki1, Yutaro Takayama2, Masaki Iwasaki2, Mai Hatano1, Waki Nakajima1, Naoki Ikegaya3, Tetsuya Yamamoto3, Shohei Tsuchimoto4, Hiroki Kato5, Takuya Takahashi1
1Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
2Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira 187-8551, Japan
3Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
4Division of System Neuroscience, National Institute for Physiological Sciences, Okazaki 444-8585, Japan
5Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita 565-0871, Japan

Tóm tắt

AbstractPresurgical identification of the epileptogenic zone is a critical determinant of seizure control following surgical resection in epilepsy. Excitatory glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor is a major component of neurotransmission. Although elevated α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor levels are observed in surgically resected brain areas of patients with epilepsy, it remains unclear whether increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor-mediated currents initiate epileptic discharges. We have recently developed the first PET tracer for α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor, [11C]K-2, to visualize and quantify the density of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors in living human brains. Here, we detected elevated [11C]K-2 uptake in the epileptogenic temporal lobe of patients with mesial temporal lobe epilepsy. Brain areas with high [11C]K-2 uptake are closely colocalized with the location of equivalent current dipoles estimated by magnetoencephalography or with seizure onset zones detected by intracranial electroencephalogram. These results suggest that epileptic discharges initiate from brain areas with increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors, providing a biological basis for epileptic discharges and an additional non-invasive option to identify the epileptogenic zone in patients with mesial temporal lobe epilepsy.

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